Ozaras. J Rheum Dis Treat 2015, 1:1 ISSN: 2469-5726 Journal of Rheumatic Diseases and Treatment Editorial: Open Access Differential Diagnosis in Upper Back Pain Nihal Ozaras*

Department of Physical Medicine and Rehabilitation, Bezmialem Vakif University, Istanbul, Turkey

*Corresponding author: Nihal Ozaras, Department of Physical Medicine and Rehabilitation, Bezmialem Vakif University of Istanbul, Turkey, Tel: +90 212 4874145, Fax: +90 212 6217580, E-mail: [email protected]

Introduction (scoliosis, kyphosis), thoracic spondylosis, stenosis, disc herniations and osteoporosis are the other reasons that can cause mechanical Upper back pain (UBP) is the pain experienced at the thoracic UBP. spine region. Spinal pain prevalence is 66 per 100 people and15% them is UBP. Although it is so frequent, it is less studied than neck Spondyloarthropathies involve upper back besides of the low or low back pain.It can be seen at any period of life, from childhood back region and they produce inflammatory UBP. It has incidious to elderly.This article briefly describes differential diagnosis in UBP. onset and improves with exercise [2]. Infectious diseases also affects thoracic spine and localized pain, tenderness, fever and neurologic UBP characteristics deficits maybe found in clinical findings [3]. Primary or metastatic UBP may be acute (<4 weeks), subacute (4-12 weeks) or thoracic tumors can cause persistent, progressive UBP that get worse chronic (>12 weeks) and it may have mechanical (related to at nights. use), inflammatory (stiffness) or neuralgic (paresthesia) pain Anamnesis is very important in musculoskeletal diseases. characteristics. But presence of the red flags (progressive pain, fever, Detailed history taking and proper laboratory/ imaging studies weight loss, malignancy,immunosuppression, drug abuse, serious usually lead to right diagnosis in patients with UBP. neurological symptoms) must always be questioned. Differential Diagnosis References Thoracic spine is connected to the rib cage and less mobile than 1. Chen CK, Nizar AJ (2011) Myofascial pain syndrome in chronic back pain cevical or lumbar spine. This structure makes the upper back less patients.Korean J Pain 24: 100-104. vulnerable to strains and sprains. But sustained overload to ligaments 2. Burgos-Vargas R, Braun J (2012) Inflammatory back pain.Rheum Dis Clin or muscles, as seen in postural alterations and work- related North Am 38: 487-499. disorders, may cause UBP frequently. Another common source of 3. Mete B, Kurt C, Yilmaz MH, Ertan G, Ozaras R, et al. (2012) Vertebral UBP is myofascial pain syndrome and the most affected muscles are osteomyelitis: eight years’ experience of 100 cases.Rheumatol Int 32: 3591- 3597. the trapezius, supraspinatus and rhomboid [1]. Spinal deformities

Citation: Ozaras N (2015) Differential Diagnosis in Upper Back Pain. J Rheum Dis Treat 1:003e Received: February 16, 2015: Accepted: February 18, 2015: Published: February 21, ClinMed 2015 International Library Copyright: © 2015 Ozaras N. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.